Hospitals can adjust their capacity over time as they try to balance avoiding being overrun versus paying to maintain empty beds. Capacity is limited by the factors of space, equipment and personnel. Hospitals initially increased their space and equipment capacity, such as procuring ventilators and retrofitting rooms for negative pressure. Although ventilators were in short supply early on, additional machines along with evolving treatment practices have reduced the scarcity and need for them.
But currently the biggest limit on capacity is personnel. This issue is handled through a variety of ways. Staff can be asked to work more overtime hours. Personnel can be shifted from other units. Experienced nurses can be trained to cover intensive care. ICU beds are particularly personnel-intensive as they often require a 1:1 or 1:2 ratio of nurses to patients.
Hospital administrators also manage utilization and capacity by postponing procedures. Initially the Louisiana Department of Health suspended all elective procedures, which was later clarified to cover all procedures that were not time sensitive. Emergencies, trauma and other time-sensitive cases would still be handled. Currently the hospitals are self-governed and tend to manage operations and scheduling in plans of two-week increments. It is also important to remember that these charts are state and regional capacity numbers. Different hospitals in the same region will face different pressures based on their individual resources and specializations. Hospitals that are more COVID-intensive might be closer to reaching their maximum capacity than these general charts would indicate.
How does COVID-19 interact with capacity?
The hospital utilization ratio has been remarkably stable with fluctuations happening within narrow bounds. Hospitals were indeed affected by the July wave of COVID cases that hit the state. An increase of COVID beds followed that wave. However, the hospitalizations were not as high as the volume of new cases might suggest. This is probably due in part to the increase in testing that detected more cases but perhaps a higher proportion of less dangerous incidents. Some of the difference also could be better treatments as well as more cases among younger and less vulnerable citizens.
The proportion of COVID patients
Of all the patients in Louisiana hospitals, how many are suffering from the coronavirus? In mid-June, 6% of all patients in Louisiana hospitals had COVID. That number rose to 16% by late July. Fortunately, this number has been declining in recent days which frees up space for hospitals to treat more non-COVID patients. Currently statewide, about 12% of all Louisiana hospital patients are in for COVID.